Reduction in lung cancer mortality is achievable through low dose computed tomography (LDCT) screening in high-risk individuals. Many countries are progressing from local LDCT screening studies to national screening programs. Implementation of effective large-scale screening programs is complex and requires a multi-disciplinary approach. A recent overview of the technical aspects of implementing high quality LDCT for screening resulted from the inaugural international expert meeting of the Alliance for Global Implementation of Lung and Cardiac Early Disease Detection and Treatment (AGILE). This covers the most important aspects of the CT imaging process: standardisation in CT image acquisition and interpretation, CT protocol management, technology developments and minimal requirements, integration of lung cancer biomarkers, and the role of AI in CT lung nodule detection, segmentation, and classification, and related data security issues.